Insertable endoscopic instrument for tissue removal

Abstract

An improved flexible endoscopic instrument to precisely and efficiently obtains samples of flat polyps and multiple polyps from a patient by debriding one or more polyps and retrieving the debrided polyps without having to alternate between using a separate cutting tool and a separate sample retrieving tool and may be used with an endoscope. In one aspect, the cutting tool is coupled to a flexible torque coil or torque rope that is configured to transfer rotational energy from a powered actuator through the length of the endoscope onto the cutting tool.

What is claimed is: 
     
       1. A method of retrieving polyps from a colon of a patient,
 comprising: 
 inserting a flexible endoscope within an opening to a colon of a patient; 
 disposing an endoscopic instrument within an instrument channel of the flexible endoscope to remove at least one polyp from within the colon, the endoscopic instrument including a cutting assembly having an outer cannula, an inner cannula disposed within an outer cannula, and an opening defined along a portion of a radial wall of the outer cannula, the inner cannula rotatably coupled to a flexible torque component having a length that extends along a length of the flexible endoscope, the flexible torque component, upon actuation, providing torque to the inner cannula; 
 providing irrigation fluid from a lavage port of the endoscopic instrument that remains outside the flexible endoscope while the endoscopic instrument is disposed within the instrument channel, the lavage port fluidly coupled to the outer cannula through an outer tubular member having a proximal end connected to the lavage port and a distal end connected to a proximal end of a rotational coupler, the rotational coupler coupling the outer tubular member to a proximal end of an outer tubing connected to the outer cannula, the rotational coupler allowing the outer tubing and the outer cannula to rotate relative to the lavage port and the outer tubular member upon rotating a portion of the rotational coupler, the flexible torque component extending through the outer tubular member, the rotational coupler, and the outer tubing; 
 rotating, via rotation of the portion of the rotational coupler, the outer cannula to a position in which the opening of the outer cannula is viewable via a camera of the flexible endoscope; 
 positioning the opening at the polyp of the colon; 
 actuating the flexible torque component to rotate the inner cannula relative to the outer cannula, the inner cannula cutting a portion of the polyp as the inner cannula rotates adjacent to the opening; and 
 actuating a sample retrieval component of the endoscopic instrument to remove the cut portion of the polyp from within the colon via an aspiration channel defined by an inner wall of the inner cannula and the flexible torque component. 
 
     
     
       2. The method of  claim 1 , wherein disposing the endoscopic instrument within the instrument channel of the flexible endoscope includes inserting a distal end of the endoscopic instrument in the instrument channel of the flexible endoscope. 
     
     
       3. The method of  claim 1 , further comprising engaging a proximal connector that is coupled to the flexible torque component and positioned at a proximal end of the endoscopic instrument with a drive assembly configured to provide torque to the flexible torque component. 
     
     
       4. The method of  claim 1 , further comprising fluidly coupling the sample retrieval component to a distal end of the endoscopic instrument to remove, from the endoscopic instrument, portions of the polyp entering the endoscopic instrument via the opening of the outer cannula. 
     
     
       5. The method of  claim 1 , wherein the flexible torque component includes a flexible torque coil having a plurality of layers of one or more threads, each of the plurality of layers is wound in a direction opposite to a direction in which one or more adjacent layers of the plurality of layers is wound and the aspiration channel is partially defined by an inner wall of the flexible torque coil. 
     
     
       6. The method of  claim 1 , wherein actuating the flexible torque component and actuating a sample retrieval component of the endoscopic instrument includes actuating the flexible torque component and actuating the sample retrieval component of the endoscopic instrument simultaneously. 
     
     
       7. The method of  claim 1 , wherein actuating the flexible torque component includes providing torque to the inner cannula that is sufficient to cut at least a portion of the polyp. 
     
     
       8. The method of  claim 1 , wherein actuating the flexible torque component includes actuating the flexible torque component to cause an inner cannula of the cutting assembly to rotate relative to the outer cannula via a foot pedal. 
     
     
       9. The method of  claim 1 , wherein the polyp is a first polyp and further comprising:
 upon cutting at least a portion of the first polyp and without removing the endoscopic instrument from the flexible endoscope, positioning the opening of the outer cannula at a second polyp within the colon; 
 actuating the flexible torque component to rotate the inner cannula relative to the outer cannula, the inner cannula cutting at least a portion of the second polyp; and 
 actuating the sample retrieval component of the endoscopic instrument to remove the cut portion of the second polyp from within the colon. 
 
     
     
       10. A method of removing polyps from within a patient, comprising:
 inserting a flexible endoscope within an opening of a patient; 
 disposing an endoscopic instrument within an instrument channel of the flexible endoscope to remove a polyp from the surgical site, the endoscopic instrument including a cutting assembly having an outer cannula, an inner cannula disposed within an outer cannula, and an opening defined along a portion of a radial wall of the outer cannula, the inner cannula rotatably coupled to a flexible torque component having a length that extends along a length of the flexible endoscope, the flexible torque component, upon actuation, providing torque to the inner cannula; 
 positioning the opening of the outer cannula at the polyp; 
 actuating the flexible torque component to rotate the inner cannula relative to the outer cannula, the inner cannula cutting a portion of the polyp as the inner cannula rotates adjacent to the opening; 
 providing irrigation fluid from a lavage port of the endoscopic instrument that remains outside the flexible endoscope while the endoscopic instrument is disposed within the instrument channel, the lavage port fluidly coupled to the outer cannula through an outer tubular member having a proximal end connected to the lavage port and a distal end connected to a proximal end of a rotational coupler, the rotational coupler coupling the outer tubular member to a proximal end of an outer tubing connected to the outer cannula, the rotational coupler allowing the outer tubing and the outer cannula to rotate relative to the lavage port and the outer tubular member upon rotating a portion of the rotational coupler, the flexible torque component extending through the outer tubular member, the rotational coupler, and the outer tubing; and 
 actuating a sample retrieval component of the endoscopic instrument to remove the cut portion of the polyp from within the patient via an aspiration channel defined by an inner wall of the inner cannula and the flexible torque component. 
 
     
     
       11. The method of  claim 10 , further comprising rotating, via rotation of the portion of the rotational coupler, the outer cannula to a position in which the opening of the outer cannula is viewable via a camera of the flexible endoscope. 
     
     
       12. The method of  claim 10 , wherein disposing the endoscopic instrument within the instrument channel of the flexible endoscope includes inserting a distal end of the endoscopic instrument in the instrument channel of the flexible endoscope. 
     
     
       13. The method of  claim 10 , further comprising engaging a proximal connector that is coupled to the flexible torque component and positioned at a proximal end of the endoscopic instrument with a drive assembly configured to provide torque to the flexible torque component. 
     
     
       14. The method of  claim 10 , further comprising fluidly coupling the sample retrieval component to a distal end of the endoscopic instrument to remove, from the endoscopic instrument, cut portions of the polyp entering the endoscopic instrument via the opening of the outer cannula. 
     
     
       15. The method of  claim 10 , wherein the flexible torque component includes a flexible torque coil having a plurality of layers of one or more threads, each of the plurality of layers is wound in a direction opposite to a direction in which one or more adjacent layers of the plurality of layers is wound and the aspiration channel is partially defined by an inner wall of the flexible torque coil. 
     
     
       16. The method of  claim 10 , wherein actuating the flexible torque component and actuating a sample retrieval component of the endoscopic instrument includes actuating the flexible torque component and actuating the sample retrieval component of the endoscopic instrument simultaneously. 
     
     
       17. The method of  claim 10 , wherein actuating the flexible torque component includes providing torque to the inner cannula that is sufficient to cut at least a portion of the polyp. 
     
     
       18. The method of  claim 10 , wherein actuating the flexible torque component includes actuating the flexible torque component to cause an inner cannula of the cutting assembly to rotate relative to the outer cannula via a foot pedal. 
     
     
       19. The method of  claim 10 , wherein the polyp is a first polyp and further comprising:
 upon cutting at least a portion of the first polyp and without removing the endoscopic instrument from the flexible endoscope, positioning the opening of the outer cannula at a second polyp at another surgical site; 
 actuating the flexible torque component to rotate the inner cannula relative to the outer cannula, the inner cannula cutting at least a portion of the second polyp; and 
 actuating the sample retrieval component of the endoscopic instrument to remove the cut portion of the second polyp from within the patient.